[Curriculum pneumologicum 2005. Part 1].
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Biomedical subjects
Publications and source records attributed to R Kroidl.
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The inhabitants of a fruit growing area often report spontaneously of sensitization to the red spider mite (RSM) (Panonychus ulmi KOCH). These are for the most part sensitizations with low clinical symptoms (rhinitis, conjunctivitis and erythema). Severe clinical developments with bronchial asthma have been observed. We investigated six patients working in a fruit growing area sensitized by RSM. The sensitizations corresponded to a Type I allergy. Skin tests and provocation tests (nasal as well as bronchial) with RSM showed immediate reactions and RAST positive results were obtained using RSM allergen disks. RAST measurements of sera from nine house-dust mite Dermatophagoides pteronyssinus allergic patients using RSM allergen disks showed RAST-class > 1 for eight patients. RAST inhibition and immunoprint suggest a possible cross-reaction between RSM and D. pteronyssinus.
Nineteen sera from patients suffering from extrinsic allergic alveolitis (bird fancier's lung, farmer's lung) and 19 sera from asymptomatic persons demonstrating IgG-antibodies were examined for IgA-antibodies against pigeon serum, Micropolyspora faeni and Aspergillus fumigatus. The IgA-antibodies against pigeon serum and Micropolyspora faeni were less of ten false-positive than the corresponding IgG-antibodies. Hence the IgA-antibodies were more specific than the IgG-antibodies. However, the sensitivity of the IgA-antibodies was lower than that of the IgG-antibodies. On the other hand IgA-antibodies against Aspergillus fumigatus were scarcely more specific than the corresponding IgG-antibodies against pigeon and M. faeni. It would thus seem that IgA-antibodies can supplement the IgG-serodiagnosis of extrinsic allergic alveolitis.
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355 out-patients with signs of bronchial asthma were studied with special reference to animal dander sensitization. Case histories allowed the clinical diagnosis of an allergy to animal dander in 75 patients (21.1%). Skin testing is a useful means, as large reactions appear in most cases of animal dander allergy (60.7% are greater than or equal to + + + -reactions). Skin reactions, however, often are "false positive" or "false negative". Therefore, bronchial provocation tests are necessary if the case history is doubtful and/or the skin reaction is less than a + + + -reaction. There is a positive correlation between skin reaction and bronchial provocation test. No negative inhalation tests were seen when the skin reaction was greater than + + +. However, a positive inhalation test can be correlated with a negative or weakly positive skin test. The probability of common structural properties of different mammalian dander allergens is discussed. Avoidance of exposure to the animal is recommended as the therapy of choice.
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